多种干预手段降低泛耐药鲍曼不动杆菌在ICU内的定植和感染：持续三年的研究
Clinical Infectious Diseases 2008;47:000–000© 2008 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2008/4706-00XX$15.00
DOI: 10.1086/591134
MAJOR ARTICLE
A Multifaceted Intervention to Reduce Pandrug-Resistant Acinetobacter baumannii Colonization and Infection in 3 Intensive Care Units in a Thai Tertiary Care Center: A 3-Year Study
多种干预手段降低泛耐药鲍曼不动杆菌在ICU内的定植和感染：持续三年的研究
Anucha Apisarnthanarak,1
Uayporn Pinitchai,2
Kanokporn Thongphubeth,1
Chananart Yuekyen,1
David K. Warren,3 and
Victoria J. Fraser,3 for the
Thammasat University Pandrug-Resistant Acinetobacter baumannii Control Group
1Division of Infectious Diseases and Infection Control and 2Medical Intensive Care Unit, Thammasat University Hospital, Pratumthani, Thailand; and 3Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri
Background.We sought to determine the long-term effect of a multifaceted infection-control intervention to reduce the incidence of pandrug-resistant Acinetobacter baumannii infection in a Thai tertiary care center.
Methods.A 3-year, prospective, controlled, quasi-experimental study was conducted in medical intensive care, surgical intensive care, and coronary care units for a 1-year period before intervention (period 1), a 1-year period after intervention (period 2), and a 1-year follow-up period (period 3). The interventions in period 2 included strictly implementing contact isolation precautions and appropriate hand hygiene, active surveillance, cohorting patients who were colonized or infected with pandrug-resistant A. baumannii, and environmental cleaning with 1:100 sodium hypochlorite solution. All interventions were continued in period 3, but environmental cleaning solutions were changed to detergent and phenolic agents.
Results.Before the intervention, the rate of pandrug-resistant A. baumannii colonization and/or infection was 3.6 cases per 1000 patient-days. After the intervention, the rate of pandrug-resistant A. baumannii colonization and/or infection decreased by 66% in period 2 (to 1.2 cases per 1000 patient-days;) and by 76% in period 3 (to 0.85 cases per 1000 patient-days;). The monthly hospital antibiotic cost of treating pandrug-resistant A. baumannii colonization and/or infection and the hospitalization cost for each patient in the intervention units were also reduced by 36%–42% ( ) and 25%–36% ( ), respectively, during periods 2 and 3.
Conclusions.A multifaceted intervention featuring active surveillance and environmental cleaning resulted in sustained reductions in the rate of pandrug-resistant A. baumannii colonization and infection, the cost of antibiotic therapy, and the cost of hospitalization among intensive care unit patients in a developing country.
Received 18 March 2008; accepted 19 May 2008; electronically published 6 August 2008.
回复 #1 David 的帖子
种干预手段主要是：1、严格接触预防
2、手卫生
3、积极监测
4、隔离定植和感染的病人
5、环境的清洁消毒。
看来对多重耐药的这些防控措施确实是有效的。
谢谢David分享！:handshake
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